Showing posts with label non availability of Neurologist for disability certificate. Show all posts
Showing posts with label non availability of Neurologist for disability certificate. Show all posts

Saturday, December 23, 2017

Santosh Kumar Vs. Secretary, Deptt of Health & Family Welfare | Case No. 4/1118/2015-Wel/CD/3492-93 | Dated: 22.12.2017




In the Court of State Commissioner for Persons with Disabilities
National Capital Territory of Delhi
25- D, Mata Sundari Road, Near Guru Nanak Eye Centre, New Delhi-2
Phone-011-23216002-04, Telefax: 011-23216005, Email: comdis.delhi@nic.in
[Vested with powers of Civil Court under the
Rights of Persons with Disabilities Act, 2016]

Case No. 4/1118/2015-Wel/CD/3492-93                      Dated: 22.12.2017

In the matter of:

Sh. Santosh Kumar,
C/o Sh. Pappu Jain,
1/1, laxmi Market, Aram Park,
Khureji, Laxmi Nagar,
Jain PG, Delhi-110092                                             ................ Complainant

                                          Versus                          
The Secretary,
Deptt. Of Health & Family Welfare,
GNCTD, Delhi Secretariat, I.P. Estate,
New Delhi-110002.                                                   ………...…Respondent


ORDER

          The above named complainant vide his complaint dated 31.08.2015 received from the Court of Chief Commissioner for Persons with Disabilities vide letter dated 21.09.2015 submitted that he applied for Disability Certificate in Multiple Disability Board of Guru Teg Bahadur Hospital, Shahdara, Delhi.  As per the complainant he has congenital blue dot and Sutural cataract in both his eyes and Diskinetic cerebral palsy in his right hand due to which he can hardly perform any household work including writing.  As GTB Hospital had no neurological facility, he was referred to IHBAS Hospital.  He alleged that during assessment, he was mentally harassed and sarcastically mocked.  He was doubted and his case was under estimated ignoring his problem.  He alleged prejudice and discrimination in gross violation of the Persons with Disabilities Act, 1995.

2.      The complaint was taken up with the respondent vide communication dated 24.09.2015.  Health & Family Welfare Department sought the comments of IHBAS Hospital.  IHBAS, Hospital vide letter dated 21.10.15 inter-alia informed that the Neurological condition of Focal Dystonia or writer’s cramp was very mild and was not contributing to any motor weakness leading to measurable disability.  The complainant was examined in different centres, AIIMS, GB Pant and Ganga Ram Hospial.  The same professional opinion was provided by the experts of those hospitals.  The hospital also stated that there was no mention of disability due to Dystonia in the disability assessment gazette.  It was also alleged that the complainant pressurised the treating Doctors to give 30% or more disability which would help him in the Civil Services Exam.  The hospital denied any harassment meted due to the complainant. 

3.      This court suggested to Department of Health & Family Welfare to appoint an Appellate Board. After exchange of a number of correspondence, the Health & Family Welfare Department asked Medical Superintendent, Lok Nayak Hospital to constitute an Appellate Board of 3 doctors for reassessment of the category of disability of the complainant as he was not satisfied with their comments/report of IHBAS Hospital and reconsider the issue of disability certificate, based on Board’s report vide letter dated 28.03.2016.

4.      A hearing was scheduled on 24.10.2017.  While the complainant did not appear, Ms. Manju Handa, Dy. Secretary on behalf of respondent informed that the complainant was also requested to contact Director, GB Pant Hospital for reassessment by Appellate Board of 3 doctors vide letter dated 08.09.2016.  However, it appeared that complainant did not visit that hospital. 

5.      It was observed that the last communication from the complainant was received on 06.11.2015.  This Court also tried to contact him on his given telephone No. 9910298747, which was switched off.  On the date of writing this order on 13.12.2017 also the said telephone number was switched off/temporarily out of service.

6.      Director, GB Pant Hospital was advised to arrange reassessment of the complainant as requested by H&FW Department and if eligible, disability certificate may be issued in respect of the complainant.  It was also made clear in the record of proceedings dated 27.10.2017 that if no response from the complainant was received by 30.11.2017, the complaint would be treated as closed.  The Record of Proceedings dated 27.10.2017 was sent to the complainant at his given address by speed post which has not been received back.  In compliance with the advice of this Court, GB Pant Hospital vide letter dated 15.11.2017 advised the complainant to report to Disability Cell, GB Pant Hospital, New Delhi between 10:00 A.M. and 4:00 P.M. with the relevant record on 16th/17th.11. 2017 or on 18.11.2017 between 10:00 A.M. to 1:00 P.M.  The hospital also found his mobile number switched off.  No response what so ever has been received from the complainant till date.  In view of this the complaint is closed and disposed off.

7.     Given under my hand and the seal of the Court this 22nd day of December, 2017.     

                                                                                               (T.D. Dhariyal )
                      State Commissioner for Persons with Disabilities


View the digitally signed PDF Order here:

Saturday, August 26, 2017

Balbir Sethi & 5 Others Vs. Principal Secretary, Health Department & 3 others | Case No. 4/1674/2017/Wel./CD/ 1616-1626 | Dated: 25.08.2017


Case Summary:

Balbir Sethi & 5 Others Vs. Health Department & Others

Disability Certificate: Complainants submitted they were struggling to get themselves or their children assessed for mental or neurological disorders from various Delhi hospitals. Hospitals cited the unavailability of neurologists to assess the disorders. Court asked them to look into possibilities of deputizing neurologists for the tasks, or co-opt them from the private sector.

During the course of the hearing, certificates started getting issued to the complainants. Court gave additional directions to enable people with such disorders to get adequate help.


Order / Judgement: 


In the Court of State Commissioner for Persons with Disabilities
National Capital Territory of Delhi
25- D, Mata Sundari Road, Near Guru Nanak Eye Centre, New Delhi-2
Phone-011-23216002-04, Telefax: 011-23216005, Email: comdis.delhi@nic.in
[Vested with powers of Civil Court under the
Rights of Persons with Disabilities Act, 2016]

Case No. 4/1674/2017/Wel./CD/ 1616-1626           Dated: 25.08.2017

In the matter of:


Sl. No.
Case No./Complainants

Respondents
1.








2.









3.













4.





5.







6.

Case No. 4/1674/2017/Wel./CD/
Mr. Balbir Sethi
R/o 46/12, Ashok Nagar,
New Delhi-110078




Case No.4/1675/2017-Wel/CD/                  
Mr. Saksham Arora
S/o Ms. Meenu Arora
BA-316, Tagore Garden
New Delhi-110027     



Case No.4/1680/2017-Wel/CD/                  
Ms. Stuti Kapoor
D/o Ms. Simmi Kapoor
18/17, West Punjabi Bagh,
J.K. Kapoor, Gate No. 03,
Ground Floor, New Delhi-110027     





Case No.4/1682/2017-Wel/CD/                  
Mr. Rajesh Verma
F/o Mr. Nischal Verma
Rajput304@gmail.com

Case No.4/1683/2017-Wel/CD/         
Ms. Kavita
B2/16B, East Raza puri
Gali No-09, Uttam Nagar
New Delhi-110059     


Case No.4/1684/2017-Wel/CD

Smt. Neelam
R-Z-41B, Majhandra Park,
Phanka Road, Uttam Nagar,
Delhi-110059
Vs.
The Pr. Secretary
Health Department,
Govt of NCT of Delhi
9th Level, A- Wing,
IP Extension,
Delhi Secretariat,
Delhi-110002                              …………..Respondent No-1



The Medical Superintendent
Janakpuri Super Speciality Hospital
C- 28, Janakpuri,        
New Delhi-110058                         …………..Respondent No-2



The Medical Superintendent
IHBAS Hospital,
GNCT of Delhi,
Dilshad Garden
New Delhi-110095                                                      ....………..Respondent No-3







The Medical Superintendent
Deen Dayal Upadhyay Hospital
Hari Nagar, Clock Tower,
New Delhi-110064

....………..Respondent No-4




Date of hearing: 11.08.2017
Present: Dr. B.K. Tyagi, AMS-II, JSSH, Dr. K.N. Mohan, S.M.O, DDU Hospital, Dr. Deepak Kumar, DMS, IHBAS, Deepak Singh, UDC, JSSH, Omprakash, Computer Asstt., IHBAS, Dr. A.K. Mishra, GB Pant.
         

ORDER

The above mentioned six complainants vide their complaints under the Rights of Persons with Disabilities, Act, 2016, herein after referred to as the Act submitted that they have been struggling to get themselves/their children assessed for mental/neurological disorders and get disability certificates from Janakpuri Super Specialty Hospital and therefore, requested that they be issued the disability certificates at the earliest.

2.      In view of the common issues involved, all the complaints are being disposed off by a common order.

3.      Brief facts of each case are indicated as under:

(i).     Case No.4/1674/2017-Wel/CD

Sh. Balbir Sethi vide his email (complaint) dated 12.07.2017 submitted that he is facing enormous problems in getting Mental Disability Certificate of his child for last 7-8 months.  He visited Ram Manohar Lohia Hospital in January 2017 who referred his child to Janakpuri Super Speciality Hospital(JSSH) in February 2017.  That Hospital did not issue the certificate due to non-availability of Neurologist in the Hospital.

(ii).     Case No.4/1675/2017-Wel/CD

Ms. Meenu Arora vide her complaint dated 17.07.2017 submitted that she had applied for disability certificate of her son on 22.05.2017 and visited Jankapuri Super Speciality Hospital.  They suggested her to apply at Deen Dayal Upadhyay Hospital who said that they do not issue mental certificate for deficiencies. She again went to JSSH who referred her son to IHBAS. IHBAS refused to issue the certificate.
       
(iii).    Case No.4/1680/2017-Wel/CD

Ms. Simmi Kapoor vide her complaint dated 17.07.2017 submitted that her daughter is suffering from severe anxiety, depression and obsessive compulsive disorder for 10 years. She was advised to get mental illness certificate by the Equal Opportunity Cell Office of Delhi University for availing reservation in admission of her daughter.  She applied for the certificate in Acharya Shree Bhikshu Hospital on 22.05.2017. She was told that certificate for mental illness can be made only at IHBAS. After visiting IHBAS on 17.6.2017, she was told that certificates are issued zone wise and she should consult JSSH.  When she visited JSSH, she came to know that the said hospital is not issuing certificate since January 2017 due to unavailability of neurologist in the medical board and she was again referred to IHBAS for certificate. After showing refusal letter provided by JSSH in IHBAS, she was referred to Deen Dayal Upadhyay Hospital (DDUH). At DDUH, Dr. Anuj Mittal, Head Psychiatrist told her that certificate for mental illness is not issued in that hospital and she was again referred to IHBAS with the refusal letter. She again applied for disability certificate of her daughter at IHBAS.  The documentation was completed on 12.07.2017. Since then, she has been requesting authorities of IHBAS to issue the certificate but neither they reverted back nor refused to issue certificate by saying that hospital does not fall under her zone. She is worried about her daughter as she is having more anxiety and pressure fearing dropping of one more year due to unavailability of documents for college admission on time.    

(iv).   Case No.4/1682/2017-Wel/CD

Sh. Rajesh Verma F/o master Nischal Verma vide his email dated 01.06.2017 submitted that he got an I.Q. test of his son conducted from IHBAS. He requested for a disability certificate. IHBAS advised him to get the certificate from his zonal hospital. He visited Deen Dayal Upadhayay Hospital, who asked him to go to Jankapuri Super Speciality Hospital. JSSHS informed him that there were no authorised doctors for signing the certificate.

(v)     Case No.4/1683/2017-Wel/CD

Brother of Ms. Kavita vide complaint dated 26.07.2017 on her behalf submitted that she had applied for disability certificate and visited Jankapuri Super Speciality Hospital who said that there was no Neurologist. Thereafter she went to DR. Ram Manhor Lohia Hospital and Safdarjung Hospital. They also refused and the JSSHS told her to get it done from the office Commissioner for Persons with Disabilities.

(vi).   Case No.4/1684/2017-Wel/CD

Smt. Neelam vide her complaint dated 26.07.2017 submitted that she is facing enormous problems in getting Mental Disability Certificate of her child.  She visited G.B. Pant Hospital, who advised her to visit Janakpuri Super Speciality Hospital.  That Hospital did not issue certificate due to non-availability of Neurologist in the Hospital.
         
4.      Medical Superintendent, Janakpuri Super Speciality Hospital, an autonomous institute of Govt. of NCT of Delhi vide his letter dated 12.01.2017 and 19.05.2017 informed that as Janakpuri Super Speciality Hospital Society had no neurologist (Asstt. Professor, Associate Professor and Professor), it was not feasible for that hospital to enrol neurology disability patients for issuing disability certificates.  The hospital would be able to start issuing disability certificates when a neurologist joined the Hospital.  He requested the Office of State Commissioner for Persons with Disabilities to amend order No.F. 82(265)AD-III/Amendment PWD Act /DSW/09/18340-358 dated 12.02.2014.

5.      The above mentioned complaints were taken up with the respondents vide Show Cause Notices of 27.07.2017 and 31.07.2017.  In the said notices, respondents No. 1 was directed to show cause as to why Specialist Doctor/Clinical Psychologist should not be deputed to Janakpuri Super Speciality Hospital on specified  dates in a week as per requirement from one of the Government Hospitals or the Medical Superintendent of the Janakpuri Super Speciality Hospital should not be advised to Co-opt a specialist doctor from private sector for the purpose or make any other arrangement to assess the disability of the persons who are struggling for disability certificates and ensure that the eligible applicants  are issued the disability certificates within the prescribed time period i.e. one week/ one month and submit Action Taken Report by 04.08.2017.  The complaints were also scheduled for hearing on 11.08.2017.

6.      The following was also brought to the notice of the respondents:
(i)      That the formats of Disability certificate prescribed in the Delhi Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Amendment Rules, also envisage assessment of disability by a specialist who may not be a Government servant.  Such a certificate would need the countersignature of the Medical Superintendent or Head of Government Hospital which implies that the Medical Superintendent or the Head of Government Hospital can co-opt a private medical specialist for assessment of a disability  and that as per Rule 4 (2) of the said Rules disability certificate shall be issued as far as possible within a week from the date of receipt of the application by the Medical Authority but in any case, not later than one month from such date.

(ii)      That as per Department of Social Welfare Notification No-  82(265)/AD-III/Amendment PWD Act./DSW/09/18340-358 Dated- 12.02.2014  (Remarks against Sl. No. 06), when any of the hospitals does not have specialities from the related specialisation, then the case can be referred by that Hospital to IHBAS and as per Note below the table, if a designated doctor of concerned field who has been authorised to issue Disability certificate is on leave or is not present, a suitable alternative arrangement will be made by the Medical Superintendent of the concerned hospital.  The Medical Superintendent will ensure issuance of disability certificate within the time period specified in Rule 4 of Delhi Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Rules, 2011 as amended. 

(iii)     That as per Department of Social Welfare, GNCTD’s Notification No. 27/8/93-H & FW/18337-355 Dated 29.08.2008, Medical Superintendent of the concerned hospital shall be the Appellate Authority to review the appeal of any dispute regarding issuance of disability certificate. In specific cases requiring cardiological/ neurological/ psychiatric examination, the Appellate Authority shall seek association of Professor in concerned speciality from GB pant Hospital, GTB Hospital and IHBAS.

7.      District wise list of 26 authorised hospitals for issuance of disability certificate (loco motor disabilities, visual impairment, multiple disabilities and mental disorders is available in the website of Social Welfare Department, Govt. of NCT of Delhi, www.delhi.govt.in/wps/wcm/connect/doit_socialwelfare/SocialWelfare+New/Home/Our+Services/Welfare+of+Persons+with+Disabilities/
Please go to http//www.delhi.gov.in.......... click
Departments
  
Social Welfare Department
  
Our services
  
Welfare of Persons with Disabilities
  
List of authorised hospitals

8.      Subsequent to the issuance of show cause notices, some of the complainants informed through emails that the Janakpuri Super Specialty Hospital had called them and after assessing the disability, certificates have either been issued or will be issued in a few days.  They therefore, requested that they may be exempted from attending the hearing on 11.08.2017.

9.      During the Hearing on 11.08.2017 Dr. B.K. Tyagi, Janakpuri Super Speciality Hospital informed that master Saksham Arora, Ms. Stuti Kapoor, Mr. Verma and Master Shubham have been issued the disability certificates after assessment by the Disability Board comprising the Neurologist, Psychiatrist and Neurosurgeon.  Ms. Kavita has been assessed and the disability certificate will be issued to her within 10 days.  Smt. Neelam who was contacted from 7th to 10th August, 2017 for hospital visit, informed that her son Master Manish Kumar was not well.  She has been advised to apply alongwith necessary documents and bring Master Manish Kumar to the hospital.  He would be assessed and issued a disability certificate as and when he is brought to the hospital. 

10.    Dr. B.K. Tyagi also informed that Health and Family Welfare Department vide order No. 11/120/H&FW/2017 HR-Med/935-40 dated 09.08.2017 has assigned one neurosurgeon and three neurologists on rotational monthly basis from Deen Dayal Upadhyay Hospital, G.B. Pant Hospital and Dr. BSA Medical College/Hospital to Janakpuri Super Speciality Hospital for assessment of persons with mental disorders and neurological disorders.  This arrangement has been made for the month of August, September, October and November, 2017.  However, he stated that Dr. Subodh Gupta, a neurosurgeon of Deen Dayal Upadhyay Hospital who has been deputed only for the month of August, 2017 is already a member of the Disability Board who is otherwise available to Janakpuri Super Speciality Hospital every month.  Because of the order dated 09.08.2017, his availability is now restricted to the month of August, 2017.  He, therefore, suggested that either another neurologist should be deputed for the regular disability board at Janakpuri Super Speciality Hospital in place of Dr. Subodh Gupta or he may be deputed on every Wednesday of all the months.  He further submitted that this arrangement or an alternative arrangement should be made beyond November, 2017 also so that disability certification happens uninterruptedly.  He also pointed out that Dr. Subodh Gupta is a neurosurgeon whereas for assessment of neurological disorders, a neurologist is required including for the month of August, 2017.

11.    The representatives of other hospitals submitted that the provisions in various notifications in connection with issuance of disability certificates should be consolidated in a single notification with more clarity particularly with regard to co-opting of specialists from private sector in the event of unavailability of a specialist in nearby government hospitals.  Since the Delhi Persons with Disabilities Rules or Central Persons With Disabilities Rules do not explicitly mention about co-opting specialists from private sector, though the format of disability certificate implies that a specialist from private sector can also assess the disability of a person which would be valid after the certificate is countersigned by the Medical Superintendent of the concerned hospital, the notification or instructions should provide for the fee of such specialists, and other terms and conditions of engagement.  For example whether there should be a formal contract for the purpose and the format thereof.  They suggested that the specialists from private sector should be empanelled by the Health and Family Welfare Department or the Medical Superintendent should be authorised for such empanelment.  They also brought out the issue of shortage of specialists in different hospitals and Health and Family Welfare Department should facilitate and ensure filling up of such vacant posts.

12.    The representatives of the hospitals also brought out the issue of guidelines for assessment of the disabilities that have been added and their certification after coming into force of the Rights of Persons with Disabilities Act, 2016 as they are receiving requests from persons who have those disabilities.  The existing Rules in the Govt. of NCT of Delhi should also be changed expeditiously so that such cases can be attended.  They also pointed out that in the existing notification dated 12.02.2014 issued by the Department of Social Welfare, the allocation of districts to various hospitals needs to be rationalised keeping in view the distance.  For example, distance between north and north west to IHBAS would be between 30 to 35 kms.  The allocation should be rationalised so that the persons with disabilities do not have to travel more than 5-10 kms.  This can be achieved by notifying various Delhi Government as well as the Municipal Corporations hospitals as the medical authorities.  The specialists from other hospitals can visit on weekly basis to such hospitals.   
                   
13.    It is observed that despite the notifications issued by Department of Social Welfare, Govt. of NCT of Delhi from time to time the concerned certifying authorities seem to be unclear about the action to be taken on their part in different eventualities in order to ensure a hassle free arrangement for assessment and issuance of disability certificates.  In the cases under consideration, the disability happens to be such that it is extremely difficult for the parents/attendants/care givers to take the affected person to different hospitals.  Inconvenience was also apparently caused due to non-availability of the Specialist Doctor in Janakpuri Super Speciality Hospital.  It is not clear whether Respondent No. 2 informed the appropriate authority i.e. Health and Family Welfare Department, Govt. of NCT of Delhi for deployment of neurologist in January, 2017 in addition to requesting the Office of Commissioner for Persons with Disabilities to amend the notification dated 12.02.2014 issued by Social Welfare Department.  It seems that had the matter been taken up with that Department for deputing the neurologist and for modification of the said notification with the Social Welfare Department, perhaps the assessment and certification of the concerned persons would not have been delayed so much.

14.    Department of Empowerment of Persons with Disabilities, Govt. of India is in the process of notifying the guidelines for assessment of various disabilities covered under the Rights of persons with Disability Act, 2016.  Social Welfare Department/Health and Family Welfare Department, Govt. of NCT of Delhi will also be notifying the Delhi Rights of Persons with Disabilities Rules and the procedure for certification, jurisdiction of the designated hospitals, etc. shortly.  Needless to say, the disability certificate is the primary document that a person with disability must possess to avail any right, entitlement or safeguards available to him/her.  Disproportionate complications and difficulties in obtaining the disability certificate may discourage many persons/family members to attempt to get the certificate and thus deprive them of their entitlements. 

15.    In light of the facts and circumstances of the cases deliberated herein above and based on the experiences of this court, the following recommendations are made:
(i)           While framing guidelines/procedures, the concerned Department should consider the experiences of the primary stakeholders particularly those persons with various disabilities or their parents/family members who had faced difficulties in obtaining the disability certificates as well as those who had positive experience and the designated hospitals so that persons with disabilities are able to get the disability certificates with ease and within the time period prescribed in the rules.
(ii)          Persons who have approached State Commissioner for Persons with Disabilities or the Nodal Departments could be involved for consultation amongst the primary stakeholders.
(iii)         Arrangement to assess the persons who cannot move by themselves and those who do not have adequate support to carry them to the hospital, should be made at the place of their residence by the concerned hospital.
(iv)        Children with disabilities who are admitted in a special school but are residing in geographical jurisdictions of different hospitals may be assessed and issued disability certificates by organising special camps in consultation with the concerned school/organisation.  Doctors from the concerned designated hospitals can be deputed in such camps.
(v)         The jurisdiction of hospitals may be considered and decided so as to keep the commuting distance to the hospitals to the minimum.
(vi)        Procedure for alternative arrangements in case of various exigencies like unavailability of specialists in a hospital, the procedure to be followed for co-opting specialists from private sector etc., should be provided for in the rules or instructions which should be widely publicised.   
(vii)      Workshops on assessment of disabilities and procedure on issuance of disability certificate should be organised from time to time for the Medical Authorities and the doctors. 
(viii)     The concerned nodal Department may also consider notifying the Hospitals under the Municipal Corporations and New Delhi Municipal Council as the medical authority/competent authority for the purpose of assessment and issuance of disability certificates.

16.     Given under my hand and the seal of the Court this 25th day of August, 2017.     

                                                                                      (T.D. Dhariyal)
                    State Commissioner for Persons with Disabilities

Copy for information & necessary action to:

The Secretary, Department of Social Welfare, Govt. of NCT of Delhi, GLNS Complex, Delhi Gate, Delhi-110002.